Pillow for Back Sleepers: What Height Is Right?

Back sleepers usually need a lower pillow than side sleepers. When you lie on your back, the pillow only has to fill the gap between the back of your head and the mattress. It should not push your head forward, and your neck should feel supported. Exactly how high the pillow should be depends on your body measurements and on your mattress.

Why do back sleepers need a lower pillow?

If you sleep on your side, the pillow has to bridge the distance between your ear and the mattress. That distance is determined by your shoulder, and it is usually much greater than when you lie on your back. You can read how to choose a pillow for that position in the guide The right pillow for side sleepers.

When you lie on your back, your whole back rests on the mattress. Your head only needs enough height to stay in line with your cervical spine. If the pillow is too high, it pushes your head forward and your chin points towards your chest. If it is too low, your head sinks backwards and your neck has too little support.

The aim when lying on your back: your head and cervical spine are in one line, and your neck is supported without your head being raised.

How can I tell that my pillow doesn't suit lying on my back?

A pillow that doesn't suit you often shows in how you sleep. These are common signs:

• Too high: Your chin tilts towards your chest, and your gaze goes forward rather than up at the ceiling. Some people therefore push their arms under the pillow at night to fold it over.
• Too low: Your head tips backwards and your neck hangs in mid-air. Many people then stuff a towel under the pillow as well.

These are indications, not a diagnosis. You can find more on this topic in Pillow too high or too low?

What determines pillow height for back sleepers?

Three things together decide the right height: your body measurements, your sleeping position and your mattress.

That is why there is no one-size-fits-all height for back sleepers. Two people who both sleep on their back can need very different pillows.

How do I work out my pillow height as a back sleeper?

Here is how to go about it:

1. Note your sleeping position and mattress. Write down which position you sleep in for most of the night. Also check whether your mattress is soft, medium or firm.
2. Take three measurements. It is best to ask someone to help you (see the table below).
3. Check the side view. Lie on your back and have someone photograph you from the side. Your head and neck should form a relaxed line, without your chin dropping towards your chest or your head tipping backwards.
4. Try it for several nights. A new pillow often feels unfamiliar at first. Only judge it after a few nights.

The page Measuring: determining your pillow size shows in detail how to take each measurement. If you would like a rough estimate of the height first, Calculating pillow height can help.

How does Pillowise work for back sleepers?

Pillowise is a made-to-measure pillow made of memory foam (viscoelastic foam). Thijs van der Hilst developed it from his experience in practice as a physiotherapist. He couldn't recommend a suitable pillow to his patients with neck complaints, so he developed his own measuring method. The pillow was created together with United Comfort Industries, who have been making ergonomic sleep products in their own factory in the Netherlands since 1990.

Your size is based on the three measurements mentioned above. Your sleeping position (back, side, stomach) and your mattress are added to that. From these, an algorithm selects the best-fitting pillow from six sizes. Each size has its own colour: pink, orange, green, blue, red and purple.

There are two ways to get measured:

• At a Pillowise stockist near you, using the Pillowise tape measure. There you will find, for example, physiotherapists, chiropractors, sleep specialists and specialist retailers.
• Yourself, with PillowScan at scan.pillowise.com. You use your smartphone or a QR code to do so.

The pillow measures 55 x 35 cm. The core is made of 100% memory foam. The cover has a moisture-regulating top layer made of Tencel and can be machine washed at 40 °C. The materials are certified to STANDARD 100 by OEKO-TEX. We give a 5-year guarantee on every Pillowise pillow. You can find out more about the product on the page The Pillowise pillow. How memory foam compares with other materials is explained in the guide Memory foam pillows.

We don't want to guess the height, but to work it out from your own measurements.

Does the right pillow help with neck complaints?

A suitable pillow helps support your head and cervical spine in a good position and gives your shoulder enough room. That can improve your sleeping comfort. It is not a cure.

Neck pain has many possible causes, and a pillow alone will not remedy it. If you regularly wake up with neck pain or your complaints persist, please have them assessed by a doctor. You can find general information in the guide Pillow for neck tension.

So: do you need to change your pillow?

Not necessarily. If you sleep on your back, wake up without complaints in the morning and your pillow doesn't push your head forward, your pillow is probably suitable. In that case you don't need to change anything.

It's a different story if you often rearrange yourself at night, fold your pillow or prop it up, or have to guess again with every purchase. In that case it is worth having your measurements taken. If you switch between your back and your side during the night, state the position you lie in for most of the time. For an overview of all the topics around choosing a pillow, see the Guide: the right pillow.

Work out your size yourself or have yourself measured. Determine your size or find a stockist near you.

Thijs van der Hilst, physiotherapist (non-practising)
Inventor of Pillowise